Lecture 3: Factors for poor fetal outcome(s) Flashcards

1
Q

What is considered full term

A

39-40 weeks

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2
Q

What is considered early perterm?

What is considered late pre term?

A
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3
Q

Does birth weight convert to how much you’re going to weigh when you’re older?

A

No

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4
Q

What is considered an extremely low birth weight?

A

2.2 pounds

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5
Q

What is considered an average birth weight?

A

5.51=8.82

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6
Q

KNOW: low birth weight = increased risk of death

Earlier their born = lower birth weight = increased risk of death

A
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7
Q
A
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8
Q

What is the leading cause of infant mortality?

A

Low birth weight

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9
Q
A
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10
Q

What is considered high birth weight?

A

8lbs 13 oz+

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11
Q

Shoulder dystocia = shoulders getting caught when coming out

Meconium aspiration = swallowing first shit because they’re in there longer

A
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12
Q

Are their long term poor outcomes w/ high birth weight?

A

No

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13
Q

What is the APGAR scoring system and what does it tell you?
* What is a perfect score?

A

Scoring system to see if the baby needs immediate help

Done right after they’re born

Not a predictor of long term outcomes

KNOW: Babies HR should be very high

10 = perfect and what we want

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14
Q

Overall Motality for babies

A

5.87

States w/ lower = longer trip to hospital / decreased education / food

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15
Q

TEST Leading causes of infant mortality

A

1) Perterm birth and low birth weight
2) Congenital malformations, deformations and chromosomal abnormalities
3) Sudden infant death syndrome
4) Materanl pregnancy complications
5) Injuries (suffication etc..)

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16
Q

Why did SIDS decrease in the 90s

A

back to sleep

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17
Q

KNOW: Assisted delivery - this is forceps or vacuum extraction

Intraventricular hemorrhage (brain bleed)
Scalp wounds
Brachial plexus injury
Collarbone or other fractures
Skull Fx
Bleeding within the skill

A
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18
Q

When does the neural tube close? if it doesnt close what happens?
* What prevents it

A

Closes at 6 weeks

Causes Spina bifida / anencephaly

50-70% can be prevented by folic acid daily before and in beginning of pregnancy
* % went down in 98 because cereals had folic acid –> rates are going up again because people are staying away from carbs/other grains

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19
Q

When do most people get prental care?

A
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20
Q

Smoking is associated w/ birth defects - people used to do this to lower birth weight
* think lower birth weight

A
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21
Q
A
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22
Q

fetal alcohol syndrome symptopms

A
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23
Q

What are the 4 fetal alcohol spectrum disorders?

A

1) Fetal Alcohol Syndrome - encompases almost everything, can see it in the facial features etc..
2) Partial Fetal Alcohol Syndrome
3) Alcohol related birth defects
4) Alcohol releated neurodevelopmental deficits

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24
Q

All 3 dysmorphic facial features

and then the other 2

A

1) Smooth Philtrum
2) Thin vermillion border
3) Small Palpebral fissures

Growth deficits
CNS Abnormality

To have fecal alcohol syndrome you need to have all these

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25
Q

NAS = babies adicted to substances

A
26
Q

TEST These are medications

A) = rare because its studies in actual pregnant women

X = probs going to do something bad but might left you survivie

A
27
Q

TEST What did folidimide do?

A

Given in the 50s for nausea, leads to limb defects

Class X

28
Q

TEST Methotrexate is what class of medication?

A

X

29
Q

TEST Acetaminaphen is what class of drug?

A

B

30
Q

Know the class for the more commonly used ones

A
31
Q

Maternal obesity side effects: (29.99+)

A

1) Miscarriage / Stillbirth
2) Birth defects
3) Macrosomia (big baby) (can lead to the baby getting those issues when coming out)
4) Preeclampsia (maternal)
5) Gestational diabetes (materanl) - don’t have to be obese for this
6) Preterm birth (basically everything causes this)
7) Future obesity and heart disease

32
Q

Maternal underweight / Low BMI side effects

A

1) Breech Delivery
2) Low birth weight
3) Per-term birth (not typically below 32 weeks)

Less risk:
* Induced labor
* C-section
* Postpartum hemorrhage

APGAR scores not typically affected

33
Q

What is Toxoplasmosis?
* How is it contracted?

A

Parasite that can affect anyone, but if it affects a pregoo woman than the baby is likely to be affected

Ingestion of raw or undercooked contaminated meat

Exposure to T, gondii oocysts through CAT LITTER - we tell pregnant women not to deal w/ cat litter

Exposure to T. gondii oocysts through soil

Contaminated water

leads to muscle pain, fever, HA in mother

Stillbirth / miscarriage
Blindness
Seizures
Developmental delay

34
Q

Cytomegalovirus
* what percent of adults over 40 have this?
* 5 problems
* Signs at birth
* Happens in how many birth
* How many of those babies w/ CMV ahve long term health issues?

A

50% of adults over 40 already have this

Problems:
* Hearing loss
* Developmental and motor delay
* Vision loss
* Microcephaly
* Seizures

Signs at birth
* Rash
* Jaundice
* Intrauterine growth resitrction
* Hepatosplenomegaly
* Microcephaly
* Seizures
* Retinitis

1/200 live births have this

1/5 babies w/ congential CMV have long term health issues
* So being exposed to it doesnt mean they’ll 100% have issues

35
Q

What two ways is zika transmitted?
* 2 things it causes

A

Transmitted by mosquitos and sexual activity

Causes:
* Microcephaly (small head)
* Severe fetal brain defects

No current outbreaks (since 2019)

36
Q

KNOW: once you get over 40 your much more likely to have adverse events in pregnancy

A
37
Q

Are you at increased risk of congenital malformation and stillbrith w/ age?

A

No

38
Q

Is Austim chance increased w/ age?

A

Yes

39
Q

Is multiple birth increased w/ age?

A

Yes, mom starts pumping out more eggs

40
Q

KNOW: mean age of mothers is getting older

A
41
Q

Does downsyndrome increase w/ mothers age

A

Significantly

NOTE: you can still have this when young, just much increased chance w/ mothers age
* Once mother is 40 all of mothers pregnancyies are classified as high risk
* 35+ = geriatric pregnancy

chromosomal anamly much more increased

42
Q

KNOW: Risk of behavories issues in the child goes up w/ mothers age
* behavior problems go down w/ mothers age

A
43
Q

this is the # of women having babies by age

NOTE teen pregnancies are down and older women are having more pregnancies due to fertility treatment

A
44
Q

Does the paternal age affect downsyndrome rate?

A

Nope, strictly maternal

45
Q

These things change w/ paternal age (not maternal)

NOTE austism is a catch all term

A
46
Q

Does fathers age affect biolar disorder or autism?

A

both!

dads age vs biopolar

47
Q

Correlation does not = causation

A
48
Q

If you are pregant w/ multiple babies what is the risk for prematurity / low birth weight?

A

60% chance (bad because low birth weight is correlated w/ mortality)

49
Q

Why is the mom at 2x risk for congential deficits including spina bifida and neural tube defects when pregant w/ multiple babies?

A

Because the mom can only absort so much folic acid / other nutrients

50
Q

Why is the baby at increased risk for intraventricular hemmorrhage leading to cerebral palsy when twins / multiple pregnancies?

A

I think its in birth something happens with getting both out?

51
Q

Twin to twin transfusion syndrome

A

1 twin sucks all nutrients - puts other twin at risk

52
Q

when mom carrying twins+
* Increased risk of c section
* increased risk of maternal preeclampsia (hypertension can lead to seizures)
* Increased risk of maternal hemorrgage after birth

KNOW: more babies (at same time)= lower birthweight

We expect twins + to be born early

A
53
Q

What is microcephaly?

A

Small head

53
Q

Lots of things can cause microcephaly
* Toxoplasmosis
* Rubella
* Cytomegalovirus
* Herpes
* HIV
* Syphilis
* Zika
* Chromosomal or genetic abnormaltities
* Syndromes
* Exposure to a known teratogen (think known toxins)

Think viruses / STDs

A
54
Q

Name the grades of the intraventricular hemorrhages

A

Grade 1: Bleeding in small area of the ventircles

Grade 2: Bleeding also occurs inside the ventricles

Grade 3: Ventricles are enlarged by blood

Grade 4: bleeding occurs in brain tissues around the ventricles

55
Q

KNOW: Most women have anemia

A
56
Q

What are the 3 things that happen w/ anemia during pregnancy

A

Pre term birth
Low birth weight
Post partum depression

Sometimes the mom will need a blood transfusion

57
Q

What is Gestational diabetes
* When does it go away
* Does it cause big or small babies
* Does it increase or decrease the babies glucose #’s when they’re born
* What are the 2 things the baby is at risk for as an adult?

A

Type 2 diabetes that happens with pregnancy

Goes away as soon as the baby is delivered

Causes massive babies

decreases babies glucose levels at birth

Risk for obesity and type 2 diabetes as adults
* The mom is also at risk for type 2 diabetes

Treated w/ diet/EX

NOTE: Baby could also have breathing issues

58
Q

What is preeclampsia and Eclampsia?

A

Preeckampsia High BP and signs of damage to another orgnan system, most often liver and kidneys
* If that BP is going up they’re at risk for seizures
* typically present w/ this general “I don’t feel good”

Eclampsia = onset of seizures after preeclampsia

59
Q

KNOW: Hypertension rates are going up in general

A